Presentation on theme: "Headache Services in Wales in Neurology and other disciplines"— Presentation transcript:
1 Headache Services in Wales in Neurology and other disciplines Dr Peter BrooksEglwysbach Medical Practice, Pontypridd&Cardiff Headache ClinicDepartment of Neurosciences,University Hospital of Wales, Cardiff
2 HEALTH POLICY IN WALES Devolved since 1999 High illness prevalence ‘Left of centre’ health policySmall private sectorLow use of private sector by governmentNo internal marketGreater emphasis on public healthLess demanding waiting list targetsNo ring-fencing of health budget
7 Neurology provision 20117 WTE consultant neurologists working from Swansea8 WTE consultant neurologists working from Cardiff4.5 WTE consultant neurologists working from Newport3 WTE consultant neurologists working in North Wales, based at the Walton centre, Liverpool
8 Neurology provision in Wales Neuroscience centres at Cardiff and SwanseaAcademics – 2 professors, 2 senior lecturersPopulation ~ 3,000,000~ 22.5 WTE consultant neurologists1 consultant neurologist per 133,000European average 1:40,000
9 Referrals to Neurology Audit one month 2010Cardiff and Vale LHB – 156 referrals47% headache, 53% non-headacheOther LHB areas – estimate >30% headache
10 Headache Service1 regional dedicated headache clinic serving South East Wales (Cardiff and Vale, Cwm Taf and Aneurin Bevan LHBs) with capacity to see approximately 190 new patients per year and 85 follow-up appointments.Established 1999 with 1 consultant and 1 Hospital Practitioner (GP)1 session per weekManpower in 2011 – 1 Hospital Practitioner with nominal consultant supervision (without headache interest); no specialist nurse; no dedicated inpatient beds.
11 Headache clinics No other dedicated headache clinics in Wales 2 consultants with an interest but with other responsibilities and a personal or institutional reluctance to develop a headache label
12 Cardiff Headache Clinic LimitationsGON injection via pain clinic onlyFlunarizine availableBotox not on formulary and not likely to be fundedNo neurosurgical specialist supportNo stimulator / neurosurgical treatments available for primary headacheNot a consultant led service
13 The future of Neurology provision? 1 new consultant neurologist planned for Hywel Dda LHB1 additional consultant neurologist planned for Cwm TafEstablish a centre for neurology in North WalesAim for 1 consultant neurologist per 80,000
14 The Future of Headache Services in Wales – barriers and considerations ‘Headache’ seen as low priority and uninteresting - ‘I hate seeing headache patients’ – Dr Consultant Neurologist‘Neuroscience implementation programme’ 2009 – not a single mention of headache, despite…….!Moratorium on all new appointments in some LHBs.
15 The Future of Headache Services in Wales Persuade planners of needs of headache patientsTentative talks in LHB areas to develop a headache clinic? Development of intermediate care servicesPrioritise attraction of a headache- interested consultant to develop regional headache ‘services.’
16 The Future of Headache Services in Wales ‘Dyfal donc a dyr y garreg’ – ‘Persistent knocking breaks the stone’‘A fo ben bid bont’ - ‘He who would be head, let him be a bridge’‘Po callaf y dyn, anamlaf ei eiriau’ – ‘The wiser the man, the fewer his words’